Plenty to think about, plenty of time.

I suffered a full rupture of my Achilles tendon playing football on Wednesday 21st October. There were no warning signs but as soon as it went I knew what had happened. I’m 32.

I was taken straight to Accident and Emergency, and less than three hours later I was back home in a cast.

The treatment I was given was excellent. But, it was all so quick I didn’t get the chance to ask all the questions I wish I had.

I’m off to the Fractures Clinic tomorrow where hopefully I can get answers to these.

In no order, here are some of the questions I hope to get answered:

1) Should I go for surgery or not? I suspect at my age that would be best, but I was told that both operative and non-operative treatments were decent options - with the understanding that non-operative treatment results in a higher re-rupture rate. However, surgery comes with a risk of complications. How big are these risks?

2) How long will I be immobile for? Will I be able to get back in to work on my crutches soon or not?

3) Will I ever be able to play football again? And when is that likely?

4) When am I likely to be driving again?

5) How is this likely to change my life in the long term? Will I always need to be cautious?

8 Responses to “Plenty to think about, plenty of time.”

  1. Hi Alex
    Sorry you have joined the club and another user from this area - I am near Peterborough.
    In response to your questions:
    1) At your age I would suggest surgery as it seems the tendon does tend to recover stronger. This must be your decision though so I would really discuss this with your surgeon. I went for surgery and then had a new keyhole technique so my scar is only 2cm long.
    2) Immobility is the hardest thing with this injury. Its a mental thing. Unfortunately it takes time to heal so expect to be in a boot or cast for between 6-10 weeks. It all depends on how quickly you heal. No driving with a right leg ATR I am afriad :( not until the boot is off.
    3) Yes of course. It usual to think this but time is a great healer.
    4) See 2 but you cannot drive with a cast or aircast boot on.
    5) Its usual to think that and yes I believe you will much more mindful of the injury but now be better prepared - stretch and warm up more!! I am only at 6 weeks and already things are picking up. Many people on here who ATR’d 6 months or so ago now say they dont even think about the rupture and just get on with things :)
    Things get better!!

  2. Thanks Graham - that’s all very encouraging.

    I’ll see what I’m advised tomorrow regarding surgery. When I was in A&E, I said to the consultant that I’d go whichever route he felt would be best. He wouldn’t tell me which one to choose though. From what I’ve read, it seems that if I was in the US, I’d go for surgery, no question.

  3. The NHS don’t really like to make a recommendation for obvious reasons. My surgeon didn’t either. I initially went for conservative but then when I got home from A&E a quick google and I found this site and some others. The next day I rang the hospital and changed my decision.

  4. I had a full left leg rupture on Oct 12. I live in the US an had surgery on the 15th. They did a knee block, so I was awake but semi out of it during surgery. Insision is about 3 1/2 inches and about 1 inch from the back of my leg toward the inside. My Doctor put me in an ace bandage with a 3 inch wide partial cast on the top of my foot (toes to knee). Only real pain after surgery was the first day after the block wore off. Really bad burning & throbing sensation. Since the second day after surgery I have only taken a couple of advil as needed. I’m a 60 year old women, so not your normal ATR type of person. Just turned wrong and down I went. I have removed my ace bandage often since surgery, I just don’t move the position of my foot when I have the cast off. Still lots of swelling, but I am up and around on crutches most of the day at home. I go to the Doctor to remove stiches on Wednesday & expect to be sent home with same partial cast for another 2 weeks. I already was given an air boot that I wore and walked with until I was able to have surgery. My understanding is that I will go into the boot for 2 months and not sure when during that time, I will be allowed to put weigh on the foot. If this is your left foot you can drive right away after surgery. Get a knee scooter to get back to work on. (roll-a-bout) I would be scared constantly of rerupture if I hadn’t had the surgery. Paulette

  5. Depending on which study you look at, the re-rupture rates are different.
    But my 2nd surgeon said (after I re-ruptered following conservative treatment) the re-rupture rate is about 1 in 5 for conservative treatment. And the strength of the tendon after surgery is closer to 90 % as opposed to about 75% with conservative treatment.
    Too bad I was not told this after the first rupture.
    As you are young and want to play football, the surgery seems to make sense.

    I do not know how many professional athletes get conservative treatment??
    I know that athlete of our town, Donovan Bailey, the world record-holder in the 100-meter dash and 1996 Olympic gold medalist, underwent surgery for his Achilles in 1998. It was a success, he came back to compete.

    The tendon needs about 6 weeks to mend, so you have to give yourself a break and keep it elevated as long as it is in cast.

    Good luck!

  6. Hi Alex,

    I started a blog and posted for the first time yesterday. I’d say I’m in a very similar position to you - check out my post and you’ll see details of my ATR; I’m a week ahead of you and did it playing squash! Did you go to Peterborough A&E? I did - I’m about 20 mins away from there but it’s the closest hospital with those facilities. I too was in for 3-4 hours, then home with a cast and I’ve been seen by a consultant in the Fractures Clinic. Going back a week on Friday.

    It’s a tough call to make. I opted against surgery after mulling it over for a day or so - 4% chance of re-rupture after surgery, 8% with conservative, I read. Surgery complications included possible skin grafts, nerve damage to the foot, infection (as with all ops, I guess). I told my consultant I’d have the surgery if there was a compelling reason to do so, and he said not - he also said he often gets asked what he would do if he suffered an ATR, and said he wouldn’t have the op.

    So that swung it for me. But, I have to be honest, I’m not 100% happy with my choice. Someone replied to my post saying they had the surgery and wished they hadn’t… and no doubt there are those who would advocate it. There doesn’t seem a right answer. Which doesn’t help much..

  7. Thanks for the comments Kevin, Paulette and 2ndtimer.

    I’ve just returned from the Fractures clinic at Addenbrookes and afte rfurther discussion with the consultant have chosen not to undergo surgery. And for the same reasons as Kevin by the sound of it.

    Kevin, like you I’m not 100% happy with my decision, but then how can I expect to be? The medical and anecdotal evidence is so split there’s no way to be sure we’re going the best way.

    The first consultant I saw was a little older than me and said he would probably opt for non-operative treatment. That’s reassuring to an extent.

    All the best with your recovery. As you’re a week ahead of me I’ll be keeping close tabs on your blog to see how things are going.
    cheers,Alex

  8. Hi chaps

    I also attended A&E at Peterborough and they offered conservative or surgery. No one was prepared to offer a recommendation above the other but I would of liked more detail from A&E and not having to rely on Google.

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